Non-profit organisation soles4souls.org says 1.2 billion people on earth live on less than US$1.25 per day. Four hundred million are children who don’t have access to one of life’s most basic necessities: a pair of shoes.

In more affluent societies, a fierce debate continues to rage over whether it’s best to let your children go barefoot all of the time.

“No”, says Andrew Shapiro, a podiatrist in private practice in Valley Stream, New York, and spokesman for the American Podiatric Medical Association.

Not wearing shoes outdoors exposes feet to obvious hazards, such as dangerous insects or reptiles, rusty nails, glass, thorns or other rash-inducing plants. Those with diabetes or vascular disease and therefore poor circulation risk slow healing and long-term damage should their feet be cut open. Potentially harmful bacteria and pollutants such as lead also lurk underfoot, says Shapiro, who believes that: “A proper shoe with good support provides shock absorption for the rest of the body and reduces stress on bones and ligaments.”

In summer, hot surfaces can burn tender young feet and cold temperatures impede walking, too. Going around barefoot in some areas at school, such as the locker room, may expose children to fungi such as athlete’s foot, toenail fungus and plantar warts. Those who walk shoeless in damp, humid environments can contract pseudomonas bacteria.

In rural areas, where soil is regularly contaminated with faeces from animals and people, children can pick up hookworm. In Ethiopia, Rwanda, Burundi, Tanzania and Guinea, children commonly pick up podoconiosis, where tiny particles of silica penetrate the skin of unshod feet walking on volcanic soil. These particles enter the lymphatic vessels, and the body reacts as if a wound is present and makes a fibrous plug that clogs the lymphatics, causing elephantiasis.

Schistosomiasis (bilharziasis) is a disease caused by parasitic worms that affects 200 million people worldwide, including school-going children in Africa. Infection occurs when skin comes into contact with contaminated water in which certain types of snails that carry schistosomes are living. The parasite leaves the snail and enters the water, where it can penetrate the skin of people. Repeated infections can damage the liver, intestines, lung and bladder.

And tungiasis, which affects about 42% of Nigerian children, is a disease caused by a parasitic flea (Tunga penetrans). The flea (also known as a jigger) burrows into the skin of the feet of the host, commonly causing bacteraemia, gangrene, tetanus and death.

Children’s lack of shoes caught the attention of young missionary worker Kenton Lee in Kenya in 2007, who thought: “Wouldn’t it be nice if there were a pair of shoes that could adjust and expand their size?”

Today, Lee’s the creator of the project The Shoe That Grows (https://theshoethatgrows.org/) in partnership with Proof of Concept in Vancouver, Washington. Says Lee, the team went
through at least eight prototypes “before settling on a high quality, durable leather and compressed rubber to make sure the shoes are flexible and strong. It uses snaps, which are less likely to break than Velcro or buckles.

“The final shoe is an ingenious sandal that uses the straps and snaps to grow up to five times in size, allowing kids to keep their shoes for years.”

Several international aid groups collaborate with Lee to get the shoes to the children who need them.